Indemnity Reduction Clause in Accident Insurance Policy Did Not Violate New York’s Consumer Protection Law
In the matter of Greene v. National Income Life Ins. Co., 2020 Slip Op 00092 (4th Dept., December 23, 2020), plaintiff, a beneficiary of her late husband’s accident insurance policy, commenced an action against the defendant, National Income Life Insurance Co., after the defendant declined to pay $18,800.00 under the policy’s hospital confinement intensive care (hospital and intensive care) benefit provisions.
Though the defendant initially paid $40,000.00 in benefits under the policy’s accidental death and dismemberment (accidental death) benefit provision, it refused to pay anything under the hospital and intensive care provisions. In doing so, the defendant relied on the indemnity reduction clause within the accident death provisions, which provided that “the benefit payable under this provision is in lieu of or will be reduced by any other benefits paid under this policy.”
Plaintiff contended that the aforementioned indemnity reduction clause was unenforceable under New York’s General Business Law §349, the statutory provision designed to protect consumers against deceptive acts or practices. The Court, however, disagreed with this argument. In doing so, it pointed out that in order to prove a violation of §349, a plaintiff must prove three elements: 1) that the challenge, act or practice was consumer-oriented; 2) that it was misleading in a material way; and 3) that the plaintiff suffered injury as a result of the deceptive act. The Court found that there was nothing deceptive about the defendant’s policy, noting that the alleged deceptive clause was “clearly written and understandable” and not “hidden in small print.” The Court also found that plaintiff “suffered no injury” and “received all the benefits to which she was entitled.”
Plaintiff’s Inability to Identify the Cause of Her Fall “Without Engaging in Speculation” Results in Dismissal of her Negligence Lawsuit Against Property Owner
In the matter of Conners v. LMAC Management, LLC, et al., 2020 Slip Op 01271 (4th Dept., December 23, 2020), plaintiff commenced a negligence action against the defendants for injuries allegedly sustained when she tripped and fell on a sidewalk owned by the defendant, LMAC Management, LLC.
The defendants moved for summary judgment seeking dismissal of plaintiff’s complaint on the ground that she could not identify the cause of her fall without engaging in speculation. In support of their argument, they submitted plaintiff’s deposition testimony, in which she testified that she felt her foot get stuck on “something.” She could not recall which foot became stuck on “something,” nor could she recall exactly where she fell. She testified that she believed that she tripped on a “crevice or a knob or something there,” but also acknowledged that she could not “really explain the fall.”
Finding that plaintiff’s testimony was “inconclusive and speculative” as to what caused her fall, the court dismissed her complaint.
Appeals Court Upholds Jury Determination that Defendant’s Response in “Emergency Situation” Was Unreasonable
In the matter of Stryker v. Conners et al., 2020 Slip Op 01928 (4th Dept., December 23, 2020), the defendant, James T. Conners, suffered a stroke while driving and crashed into a vehicle being driven by plaintiff, Gregory Stryker. Plaintiff commenced a lawsuit against Mr. Conners and Connors & Conners Inc. for injuries sustained in the accident. Following a jury trial, the jury determined that defendant was faced with an emergency situation that could not have been reasonably anticipated. Nonetheless, the jury held the defendant liable for causing the accident on the ground that his response to the emergency was not that of a “reasonably prudent person.”
The defendant appealed the verdict, arguing that the jury’s finding that he faced an emergency situation that he could not have reasonably anticipated necessarily precluded a finding of negligence.
The Appellate Court rejected this argument, noting an individual confronted an emergency situation may not be found negligent, but only if the actions taken in response to the emergency are “reasonable and prudent in the emergency context.” Stated differently, under New York Law, a person confronted with an emergency situation may still be found liable where “his or her reaction [to the emergency situation] is found to be unreasonable.”
The Court found that the jury’s determination that the defendant’s reaction to the emergency was unreasonable was not “against the evidence.” In reaching that decision, the Court stressed that the defendant began experiencing symptoms of illness two hours prior to the collision, but nevertheless, continued to drive. Based on those facts alone, the Court believed that the jury’s verdict could have been reached by a fair interpretation of the evidence. Thus, the Court upheld the verdict and dismissed defendant’s appeal.
Defendant’s Proof Insufficient to Establish That the Alleged Defect that Caused Plaintiff’s Fall was “Trivial”
In the matter of Amos v. School 16 Associates LP, Slip Op 00017 (4th Dept., December 23, 2020), plaintiff commenced a lawsuit for injuries sustained when she tripped and fell on a crack in the sidewalk adjacent to property owned by defendant School 16 Associates. The defendant moved for summary judgment seeking dismissal of the complaint on the ground that the defect, i.e., the crack in the sidewalk, was too trivial to constitute a dangerous condition. In support of its motion, the defendant produced evidence showing plaintiff’s right toe became caught in a sidewalk crack that had a height differential ranging from half an inch to one inch and which was located in the vicinity of several other cracks. Nonetheless, the Supreme Court found that this evidence was insufficient to prove that the defect was “trivial” as a matter of law. The defendant appealed the decision; however, the Appellate Court agreed with the Supreme Court’s reasoning and affirmed its decision.
Prepared by Dominick F. Roa